Blue Baby Syndrome: Symptoms, Causes & Treatment

Blue Baby Syndrome, also known as Infant Methemoglobinemia or Cyanosis, is a medical condition that results in blueness of skin in babies. It is caused due to a decreased amount of hemoglobin in the infant’s blood. The bluish or purple tinge appearance of the skin is generally seen in areas where the skin is thin. These areas may include lips, earlobes, and nail beds. Genetic factors, environmental factors, or several other congenital heart defects can cause the blue baby syndrome.

Symptoms of Blue Baby Syndrome

The most common symptom of blue baby syndrome is the blue discoloration of skin around the feet, hands, and mouth, indicating insufficient oxygen intake.

Other symptoms of Blue Baby Syndrome may include:

• Vomiting
• Difficulty in breathing
• Increased salivation
• Diarrhea
• Loss of consciousness
• Lethargy
• Seizures
• Irritability
• Feeding issues
• Inability to gain weight
• Developmental issues
• Rapid heartbeat
• Death (in extreme cases)

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Causes of Blue Baby Syndrome

Under normal conditions, the heart pumps blood to the lungs for oxygenation. This oxygenated blood is circulated back to the heart and then to all other parts of the body. When there is a problem with the heart, lungs, or blood, the oxygenation of the blood doesn’t take place properly, causing the bluish color of the skin.

The lack of oxygen in the blood can be due to several reasons:

Tetralogy of Fallot (TOF):

This is a serious congenital heart defect which is a primary cause of Blue Baby Syndrome. It involves four heart structural abnormalities that reduce the flow of blood to the lungs and increase deoxygenated blood flow into the body.

Tetralogy of Fallot may include conditions like having a hole in the wall of the heart that separates the right and left ventricles of the heart.

Methemoglobinemia:

This condition is caused by nitrate poisoning. It occurs in children who are fed infant formula mixed with well-water or food items rich in nitrates like spinach, beetroot etc. It mainly affects children under six months of age as they are very sensitive and their gastrointestinal tract is underdeveloped which is more likely to convert nitrate into nitrite.

Circulation of nitrite in the body produces methemoglobin which does not release oxygen in the bloodstream and turns the skin of the baby’s blue.

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Other congenital heart defects:

Congenital heart defects can also be inherited, similar to babies born with Down syndrome have heart defects. Additionally, poor maternal health and uncontrolled type 2 diabetes can cause heart defects in developing babies.

Diagnosis of Blue Baby Syndrome

Blue Baby Syndrome in infants is generally suspected by doctors during regular health checkups. Parents should schedule an appointment with the doctors as soon as they notice bluish or purple discoloration in their babies’ skin.

At Yashoda Hospital & Research Centre, Nehru Nagar, Ghaziabad, doctors conduct various diagnostic and screening tests following a physical examination, thorough medical history, and discussions with parents about symptoms, feeding patterns, and home conditions.

The tests conducted, along with the physical examination, include:

• Blood tests
• Chest X-ray to examine the size of lungs and heart
• An electrocardiogram (EKG) to observe the electrical activity of the heart
• Echocardiogram to look at the anatomy of the heart
• Cardiac catheterization to visualize blood vessels of the heart
• Oxygen saturation test to analyze the level of oxygen in the blood

Treatment of Blue Baby Syndrome

Treatment for Blue Baby Syndrome depends on its cause. An infant is most likely to undergo surgery if the discoloration is due to congenital heart defects. It is usually performed before the child turns one, to correct abnormalities and improve oxygen levels, thus alleviating the bluish appearance.

Certain medications may also be prescribed by doctors, depending on the severity of the defect.

Children with mild forms of blue baby syndrome are monitored to make sure that they do not develop any further health problems as a result of the condition.

Children with severe conditions may need a medicine called ‘methylene blue’ which can reverse the effect of Methemoglobinemia by providing oxygen to the blood. This medicine is prescribed and administered through a vein by doctors.

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Prevention of Blue Baby Syndrome

Here are some ways that can be used to prevent the Blue Baby Syndrome:

• Avoid giving well water to children under 12 months of age for drinking or preparing formula milk.
• Avoid giving food items rich in nitrates such as broccoli, spinach, beetroot, carrots, etc. to babies.
• Pregnant women should avoid smoking, alcohol, illicit drugs, and some specific medications to prevent congenital heart defects.
• Proper management of diabetes during pregnancy is crucial.

Best Doctors for Treating Blue Baby Syndrome:

Dr. Yatin Arora is a Consultant in Cardiothoracic & Vascular Surgery at Yashoda Hospital and Research Centre, Nehru Nagar, Ghaziabad. Dr. Arora holds an M.Ch. from AIIMS. With extensive experience, he has contributed to publications and provided teaching and surgical assistance.

Dr. Ankur Agrawal is a Cardiothoracic & Vascular Surgeon at Yashoda Hospital and Research Centre, Nehru Nagar, Ghaziabad. Dr. Agrawal specializes in adult & pediatric cardiac, thoracic, and vascular surgeries. His compassionate approach and expertise ensure optimal patient care.